Session 11 Flashcards
(47 cards)
What makes up the anterior circulation of the brain?
Internal carotid artery
Middle cerebral artery
Anterior cerebral artery
Posterior communicating artery
What makes up to posterior circulation of the brain?
Basilar artery
Vertebral artery
Posterior cerebral artery
Give two branches of the internal carotid artery.
Ophthalmic artery
Posterior communicating artery
Anterior choroidal artery.
Which structures do the posterior communicating arteries supply?
Midbrain, thalamus, temporal and occipital lobes.
What is a stroke?
Abrupt loss of focal brain function lasting more than 24 hours, that is either due to spontaneous haemorrhage into the brain or inadequate blood supply.
What is a TIA?
Sudden onset, with focal disturbance of brain function, which is presumed to be of vascular origin, and resolves within 24 hours.
Give three causes of cerebral infarcts.
Large vessel atheroma Cardiac embolism Small vessel disease Blood disorders Cryptogenic
Give three causes of intracerebral haemorrhage.
Hypertensive/microaneurysms
Amyloid angiopathy
Haemostatic anticoagulant
Cocaine/ amphetamines/ tumour.
What is a TACS?
Total anterior circulation stroke. ICA or proximal MCA. Contralateral hemiparesis, hemianopia and higher cerebral dysfunction.
What is a PACS?
Partial anterior circulation stroke. Occlusion of MCA.
What is a LACS?
Lacunar stroke. Single perforating artery.
What is a POCS?
Posterior circulation stroke. Brainstem, cerebellar or occipital involvement.
Give three differentials of a stroke.
Hypoglycaemia Epilepsy SOL Demyelination Retinal bleed Migrainous Aura
Describe the treatment of a stoke.
IV thrombolytics within 3 hours of onset.
Endovascular intervention.
Early aspirin therapy.
Management in an acute stroke unit.
Give two ways to prevent a stroke.
Antithrombotic, treat risk factors such as hypertension, hypercholesterolaemia and diabetes, lifestyle changes.
What does FAST mean in terms of a stroke?
Facial weakness, arm weakness, speech porblems, time to call 999.
Describe the blood supply of the spinal cord.
Anterior spinal artery (anterior 2/3 of spinal cord)
Posterior spinal arteries (posterior columns)
21 pairs of segmental arteries
Artery of Adeamkiewicz.
Give three causes of anterior spinal artery occlusion.
Aortic disease, aortic surgery, vasculitis, sickle cell disease, hypotension, disc herniation.
Give two differentials of a spinal artery occlusion.
Mass lesion, acute inflammation, demyelination, sarcoid, TB, syphilis.
What is the decorticate response?
Severe injury to hear or large infarct destroys connections between thalamus and cortex (above the red nucleus). Lower limbs become extended and the arms flexed. Hands clenched and the feed turned inwards.
What is the decerebrate response?
Damage to lower brain or brainstem (below the red nucleus). Complete extension of lower and upper limbs, as well as the head.
What is an extradural haemorrhage?
Arterial bleed between the skull and parietal layer of the dura. Typically regain consciousness, but deteriorate over the next few hours.
What is a subdural haemorrhage?
Venous bleed between the dura and arachnoid mater. Tends to be crescent shape on CT and limited by dural reflections.
What is a subarachnoid haemorrhage?
Arterial bleed between the pia and arachnoid mater. Presents with a thunderclap headache at the back of the head, neck stiffness and vomiting. Increased whiteness around the subarachnoid space. Blood within the CSF seen on lumbar puncture.
